Vehicle Safety Inspection

• Vehicle ID Number

• Vehicle Make and Model

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Check that all Drivers have been approved to drive Painters USA Vehicles

  Yes

  No

  N/A

• List Drivers Below

• Odometer Reading

Damage Check List

• When "At Risk" is selected option to add comments and photo is enabled

• Check Ignition Key (Bent, Worn etc)<br>

  Safe

  At Risk

  N/A

• Check Windshield integrity (cracks/chips)

  Safe

  At Risk

  N/A

• Check Windshield Wipers / Washers (front and rear)

  Safe

  At Risk

  N/A

• Visual Inspection for Exterior Damage <br>(Recommend taking pic of any vehicle damage and report to FL)

  Safe

  At Risk

  N/A

• Check License Plate Sticker is Current

  Yes

  No

  N/A

• Check Service Sticker (on windscreen) for scheduled service date/mileage

  Safe

  At Risk

  N/A

• Check for Leaks under the vehicle

  Safe

  At Risk

  N/A

• Check inside the engine compartment for any leaks and loose items

  Safe

  At Risk

  N/A

• Check Oil Level

  Safe

  At Risk

  N/A

• Check Washer Fluid Level

  Safe

  At Risk

  N/A

• Check Coolant Level

  Safe

  At Risk

  N/A

• Check Power Steering Fluid Level

  Safe

  At Risk

  N/A

• Start Engine and Check Transmission Fluid

  Safe

  At Risk

  N/A

• Check Tires for Wear and Pressure, inc. spare (Manufacturers specification pressure)

  Safe

  At Risk

  N/A

• Check Heater / Defroster / Air conditioner

  Safe

  At Risk

  N/A

• Check Headlights / Turn Signal Lights / Hazard Lights / Tail Lights / Reverse Lights

  Safe

  At Risk

  N/A

• Check Mirrors for Damage and Adjustments

  Safe

  At Risk

  N/A

• Check Wheel chocks, Warning Signs, Jack and Spare Tire

  Safe

  At Risk

  N/A

Inside of Vehicle Check List

• Check that the inside of Vehicle is clean and Free of debris <br>

  Yes

  No

  N/A

• Check Current Registration Card

  Yes

  No

  N/A

• Check Current Insurance Card

  Yes

  No

  N/A

• Check That Seat Covers are in place?

  Yes

  No

  N/A

Truck Box Checklist

• Jumper Cables

• First Aid Kit

• Window Scraper

• Fire Extinguisher

• 3 way Trailer hitch

• Pintel Trailer Hitch

• Trailer Hitch Pin and Lock

• Ratchet Straps (x4)

• Driving Plan- List who will be driving for what length of time. List estimated time between stops, miles to job site or hotel if more than single day drive, etc... *No Driver Shall exceed 6 hours of continuous driving*

• As an employee and approved driver of Painters USA Inc. I am the foreman or driver responsible for the care of this vehicle for the duration of the Job listed below and have filled out this form to the best of my ability, with the understanding that I am expected to report any damage or lost items that may occur prior to or during its use immediately and will be held responsible if I fail to do so.

• Job Name and Duration

• Signature of Driver #1

  Sign

• Signature of Driver #2

  Sign

• Signature of Driver #3

  Sign

Vehicle Return

• I Agree that the above vehicle was returned in the same fashion as it left the shop, or will include notes on the specifics otherwise.

• Returned On Date

  Date

• Signature of Returning Driver

  Sign